Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01923 | Date 12/11/2018 |
| Token No | SM/18-19/3637 14/11/2018 | Serial | 026 Last Visit: 14/11/2018 |
| Patient Name | Mrs. MOUSUMI HALDER | Contact No | 9748957825 |
| Address | 85 A P GHOSH ROAD | Age | 33 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||